Provider Demographics
NPI:1588765903
Name:VANTAGE EYE CENTER A MEDICAL CORP
Entity type:Organization
Organization Name:VANTAGE EYE CENTER A MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROOKFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-598-7488
Mailing Address - Street 1:63 S ROCKFORD DR STE 220
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-6226
Mailing Address - Country:US
Mailing Address - Phone:831-771-3900
Mailing Address - Fax:831-771-3966
Practice Address - Street 1:622 ABBOTT ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4315
Practice Address - Country:US
Practice Address - Phone:831-771-3900
Practice Address - Fax:831-771-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ13274ZMedicare ID - Type Unspecified